Paediatric cardiac services in the Occupied Territories of Israel( Pop 3.8 M)are inadequate due to the tragic political situation and resultant socioeconomic deprivation.At least 500 children need surgery annually..
The Palestine Children's Relief Fund, a secular, apolitical US NGO has sponsored and coordinated a program at the Makassed Hospital in East Jerusalem to serve West Bank and Gaza. Objectives are provision of a near-continuous service by international teams,provision of facilities and equipment and recruitment and training of staff with the goal an autonomous service.Groups from Belgium, Italy, France, England, New Zealand and USA have made regular visits.Facilities provided include a dedicated fully equipped OR,a 7 bed ICU and 2 echo machines.
Between Sept 2003 and Dec 2008 764 operations have been performed (2003 27, 2004 111, 2005 144, 2006 102, 2007 192, 2008 188.) Overall mortality is 3.9%.Over the same period European donations have allowed referral of some children to Israeli hospitals.This has allowed progression at Makassed hospital towards younger and more complex cases without significant increase in mortality. Many operations are now done with the sole support of Palestinian staff.
Differences in philosophy and protocols between visiting groups have been minimized by annual meetings and discussions.Ongoing problems include patient and staff access, follow-up care and staff recruitment and training.
This model of cardiac care for children in a combat zone has proved effective and may be unique.